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A 60 year old patient presenting chronic mesenteric Ischemia (CMI) was managed with superior mesenteric artery (SMA)stenting as bridge therapy to conventional open surgery. At 5 months follow-up, the SMA stent occluded. During thisbridge period the patient gained his general condition and the body mass index (BMI) increased from 18 to 22. Thepatient was managed subsequently with iliac-SMA bypass in C-loop configuration. At 6 months follow-up the bypass ispatent, the patient has no CMI symptoms and his BMI is 25. The endovascular approach did not preclude a subse-quent conventional open surgery and it can be safely employed as bridge therapy. An improved patient clinical condi-tion, also during a limited bridge period, can improve the conventional open surgery outcomes.